| NPI | 1679302517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK DENGLEGI Vice President 848-221-0297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-07-30 |
| Last Update Date | 2024-07-30 |