| NPI | 1255816302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LYNN RAUSCH Director 706-421-0289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |