| NPI | 1427639574 |
|---|---|
| Doing Business As | GLEN DALE CENTER |
| Entity Type | Organization |
| Authorized Contact | SHARON C' DE BACA Executive Assistant To President 502-538-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2022-10-25 |