| NPI | 1710721519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI MOORE Owner 870-224-5212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2024-06-25 |