| NPI | 1659254415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE L COURTNEY CEO 870-723-9049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2025-07-29 |
| Last Update Date | 2025-07-29 |