| NPI | 1346852746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY CROWNOVER Program Director 747-265-9704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |