| NPI | 1679357602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALITA SMITH Owner 437-739-2084 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-21 |