| NPI | 1912465295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIERNEY JAMES Business Manager 501-313-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2019-03-06 |