| NPI | 1245635549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE WIEBER CEO 567-343-1966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2024-05-30 |