NPI | 1518492362 |
---|---|
Entity Type | Organization |
Authorized Contact | BRYAN FIKES CEO 662-372-1691 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2017-04-28 |
Last Update Date | 2025-01-02 |