| NPI | 1811861255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA WADDELL Administrative Officer 844-473-6378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 251B00000X Case Management | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-09-30 |
| Last Update Date | 2025-09-30 |