| NPI | 1013656180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERITA C CHANG Cro 954-993-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2024-06-12 |