| NPI | 1326713215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH RACKLEY Office Manager 870-243-8650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2022-06-02 |