| NPI | 1871487033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE PAYNE VP Operations 551-777-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-07-21 |