| NPI | 1003641846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIGI VACCARO Billing Manager 561-360-9589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-09-03 |