| NPI | 1609614379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGH KANE Operations Manager 606-303-0785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2024-08-29 |