| NPI | 1306359906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATELYN FISHER Director Of Operations 267-669-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: PA 157771) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2024-04-04 |