| NPI | 1750277893 |
|---|---|
| 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 | 2025-06-16 |
| Last Update Date | 2025-06-16 |