| NPI | 1518830892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE TROUTMAN Supervisor Of Billing 800-678-2332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-09-24 |
| Last Update Date | 2025-09-24 |