| NPI | 1649016924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALI PETERSON Executive Director 877-835-1545 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2024-07-05 |