| NPI | 1770219453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC CONLEY CEO 772-353-1089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-07-26 |