| NPI | 1154098853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA RENAE WILLIAMS Co Owner 229-347-1758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QR0800X Clinic/Center, Recovery Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-08-30 |