| NPI | 1801248919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDEN COLUCCIO CFO 877-636-9322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: PA 097105) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |