NPI | 1376157032 |
---|---|
Entity Type | Organization |
Authorized Contact | KENDALL MCCULLAR Credentialing Specialist 225-900-8940 |
Organization Subpart ? | Yes |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2020-09-01 |
Last Update Date | 2020-09-01 |