| NPI | 1689878639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL EPLEY Intemin Executive Director 386-736-0420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1264AD8975-00) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2008-06-06 |