| NPI | 1710511068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA NEAL Director Of Managed Care 629-257-8260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2025-08-28 |