| NPI | 1356091789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY DAVIS Revenue Cycle Manager 872-235-0258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-03-28 |