| NPI | 1265856017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL KEITH KELLEY Chief Medical Officer 754-300-3120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2015-05-06 |