| NPI | 1669928917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLA RAJARAM Billing Manager 9546-276-1547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |