| NPI | 1841418514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MILES COWAN Executive Director Owner 5802-376-5443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |