| NPI | 1871276105 |
|---|---|
| Other Name | COBB OUTPATIENT DETOX, LLC |
| Entity Type | Organization |
| Authorized Contact | SHANNON ERB Manager 859-304-4047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2023-08-11 |