| NPI | 1922855816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL WILLIAMS Owner 225-278-6082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2024-11-25 |