| NPI | 1366153454 |
|---|---|
| Doing Business As | 29 11 HEALING AND RECOVERY CENTER |
| Entity Type | Organization |
| Authorized Contact | VICKIE POULSON CEO 870-716-9365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-12-08 |
| Last Update Date | 2025-12-04 |