| NPI | 1386932523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN SHEETS President/CEO 026-351-6986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: AZ BH-3902) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2023-11-09 |