| NPI | 1164087458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN WOLF CEO 888-712-8480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2024-06-14 |