| NPI | 1528698321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY BLAIR ELDER Rcm 737-247-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2025-09-03 |