| NPI | 1801069059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN MARIE TAYLOR Managed Care Supervisor 888-924-3786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: IL 0126-0006) | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2023-03-16 |