| NPI | 1386327328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY THOMAS Adminstrator 888-462-4496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2025-05-22 |