| NPI | 1124616479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN KROLL Owner 810-300-8536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261QR0800X Clinic/Center, Recovery Care | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2021-01-21 |