| NPI | 1013656180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL JACOB CEO 786-307-3952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2025-09-25 |