| NPI | 1932633427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SIEBERT Director Of Compliance 390-685-1047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2025-04-11 |