| NPI | 1336833474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYREE BROWN Manager/Owner 267-240-7333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-06-02 |