| NPI | 1285482075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DIONNE DUDLEY Owner 469-608-0295 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-05-08 |