| NPI | 1386227940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MCCALL Program Director 877-768-5544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2026-05-21 |