| NPI | 1427531169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCH FRANCES Program Director 870-773-4655 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |