| NPI | 1962147082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAKINA DEAN Chief Executive Officer 267-278-1079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-05-03 |