| NPI | 1669027801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARISMA GOVAN-FACEY Co Owner 800-484-8007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 174200000X Meals | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2019-08-05 |