| NPI | 1538753942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NURYS B PUENTE Revenue Cycle Director 855-459-4599 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2021-02-25 |