| NPI | 1255973210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTEECA ECCLES Owner 980-474-9219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2019-10-11 |