| NPI | 1265887277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MAE DEPOLA President 929-295-2093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |