| NPI | 1659026565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DIFABIO Cmo 770-203-3998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2022-02-18 |