| NPI | 1801170543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEREDITH BARRY Manager 800-990-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1550AD301301) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2014-03-14 |