| NPI | 1760257224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYER WEBER Owner 347-374-1767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2024-11-05 |