| NPI | 1487090783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASPER CROSBY Clinical Therapist 267-847-1320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2013-05-14 |