| NPI | 1932674538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI-ANNE SPILLER Program Director 239-333-8079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2019-03-12 |