| NPI | 1609203447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMIE KLEIN Owner 606-615-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2013-10-10 |