| NPI | 1417392762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GRANT NIZNIK Owner/CEO 855-633-6130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1113AD185301) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2022-10-25 |