| NPI | 1114498813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDRA SABANAGIC Director Of Revenue Cycle 872-810-3540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2018-12-07 |
| Last Update Date | 2020-05-15 |