| NPI | 1477322766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED DANIEL COAD Managing Member 520-501-1458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2023-12-27 |