| NPI | 1689298648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PRIESING Administrator 800-935-2305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-06-04 |