| NPI | 1396498044 |
|---|---|
| Doing Business As | MAGNOLIA CITY DETOX |
| Entity Type | Organization |
| Authorized Contact | JAMES F WITTECK CEO 772-563-8518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2022-06-01 |