| NPI | 1326760596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MORIARTY Managing Member 424-388-4061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2022-09-14 |