| NPI | 1760846232 |
|---|---|
| Doing Business As | BROOKSIDE |
| Entity Type | Organization |
| Authorized Contact | AMBER SISCO Owner 606-658-3078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2023-04-18 |