| NPI | 1982382578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA LASANDERS WARD Member/Organizer 252-200-8608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2024-12-27 |