| NPI | 1912402173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAREK OGANYAN Operating Officer 747-204-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |