| NPI | 1467005744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMERIA D SPEARMAN CEO/Director 380-867-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 314000000X Skilled Nursing Facility | |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-16 |