| NPI | 1568359198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL TERRON BARBOUR Owner 606-215-2328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-06-18 |