| NPI | 1881551174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL BOYLE Director, Credentialing 737-600-6039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2026-01-07 |
| Last Update Date | 2026-03-20 |