| NPI | 1306524285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL BOYLE Director, Credentialing 737-600-6039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2024-04-24 |