| NPI | 1912777046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA RENEE MULLINGS Director Of Compliance 834-769-8758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-01-09 |