| NPI | 1508698671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KOLIN Authorized Official 877-959-8180 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-08-16 |