| NPI | 1457232589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY BLAIR ELDER Rcm Director 737-247-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-09-08 |
| Last Update Date | 2025-09-11 |