| NPI | 1851007272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAYDEN YOUNGHUSBAND CEO 000-000-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-04-23 |