| NPI | 1750075024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SITUMBA STANSBERRY Alcohol And Drug Counselor 888-226-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2023-06-08 |