| NPI | 1558114827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED TURNER Billing Manager 772-812-9652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2024-04-08 |