| NPI | 1972760130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE TRAHANT Director 877-413-3073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: GA 050724) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2013-02-26 |