| NPI | 1952175200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMMANUEL GEBREYSUS HIDRU Manager 172-031-9184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2023-11-07 |