| NPI | 1750052924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENA KROEBER CFO 385-312-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2021-09-27 |