| NPI | 1639675143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASALLE NOREEN HARRIS Executive Director 234-678-9805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2022-04-27 |