| NPI | 1306498043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHEYENNA RUNYON Director Of Credentialing 606-638-0938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2023-11-27 |