| NPI | 1962961599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TUBTSHWM WASHINGTON YANG Owner/Manager 866-511-6623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-03-13 |