| NPI | 1578234225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN VARTANIAN CEO 774-318-4270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2025-09-29 |