| NPI | 1669401816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE DAN BEAVERS CEO 270-901-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2023-06-07 |