| NPI | 1497144158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY NITZ Business Manager 861-921-6142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2015-01-20 |