| NPI | 1962037010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPERLISHA AYENI Administrator 270-900-4179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |