| NPI | 1700646163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANAKI NICASTRO Credentialing Manager 919-442-1837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-10-27 |