| NPI | 1639803638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE MIRANDA Director Of Operations 940-736-5674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2023-06-13 |