| NPI | 1316417397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN WILLIAMS Financial Controller 877-831-2533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2018-12-03 |