| NPI | 1609577311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RODGERS Cmo 267-687-9008 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2023-03-10 |