| NPI | 1336760222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK JOHNSON CEO 980-505-2353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2020-05-01 |