| NPI | 1003190406 |
|---|---|
| Doing Business As | IATAC |
| Entity Type | Organization |
| Authorized Contact | SUZANNE LUTZ Administrator 954-999-0818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2024-10-04 |