| NPI | 1649854985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON BARSALOU Operations Manager 855-920-5310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2022-05-18 |