| NPI | 1982218228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOSEF SCHUCK CEO 848-221-0780 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2020-09-11 |