| NPI | 1114746989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNY KOPIT BADLERMOCK CEO 747-361-5154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2026-02-10 |