| NPI | 1891403275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS RYAN Managing Partner 855-762-3796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-11-14 |