| NPI | 1023682721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG BREWTON Owner 954-593-2082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2021-07-23 |