| NPI | 1356022834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATIYA GROOMES Managing Member 267-977-0121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 177F00000X Lodging |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2023-07-27 |