| NPI | 1699430264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA RENEE STAMP Director Of Billing 800-545-9031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2022-06-09 |