| NPI | 1851704449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA TUCKER CEO 777-219-1355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2015-09-08 |