| NPI | 1427278837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYEAST REYNOLDS Director Of Rcm 678-813-0428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: AZ BH-1594) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: AZ BH-1594) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2019-04-11 |