| NPI | 1396096376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE FLORES Account Specialist 754-201-2265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |