| NPI | 1790243640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA YOUNG WILLIAMS Authorized Official 800-844-3149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-12-09 |