| NPI | 1699468488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM GRAY Board President 605-270-7223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-10-02 |