| NPI | 1881585719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAVONTE WILLIAMS Owner 567-970-9135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-10 |