| NPI | 1598422875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE BAHBAH Director Of Rcm 754-270-6654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2021-11-22 |