| NPI | 1932966397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA THOMAS Program Director 857-327-7442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-04 |