| NPI | 1962211433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY ERBER Owner 062-225-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2025-04-11 |