| NPI | 1568950236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BRUGGEMAN Managing Member 833-210-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 4290-4291) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2020-09-01 |