| NPI | 1437614583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON HOLMES CEO 667-400-6206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2024-12-26 |