| NPI | 1164897658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN J FISHER Executive Director 888-316-2902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2015-12-09 |