| NPI | 1598201444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DNESHA MOORE Account Manager 800-990-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 0601) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2022-07-21 |