| NPI | 1962087098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANDRA SALLEY Director Of Operations 980-234-9847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2021-03-17 |