| NPI | 1962049684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN CASEY President 740-415-1138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2024-10-22 |