| NPI | 1932560638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMAD BRYANT CEO 866-710-0707 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 4683) |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2016-03-21 |