| NPI | 1154789766 |
|---|---|
| Other Name | 12 SOUTH RECOVERY |
| Entity Type | Organization |
| Authorized Contact | KYLE SMITH CEO/Owner 888-830-8374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2022-11-02 |