| NPI | 1679094031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM B. ZAGHA Chief Administrative Officer 424-835-6506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2017-07-06 |