| NPI | 1336789478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYNE SUNDHOLM CEO 888-330-2532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2025-11-04 |