| NPI | 1548848567 |
|---|---|
| Doing Business As | TCOA 2325 |
| Entity Type | Organization |
| Authorized Contact | JENNIFER SLIS R Cm 772-248-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2024-12-02 |