| NPI | 1316719974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAIAH DAHL Co Owner 334-237-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-26 |
| Last Update Date | 2023-10-26 |