| NPI | 1528642295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON OBENOSKEY Executive Director 512-618-3484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2021-11-22 |