| NPI | 1033558796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA IACULLO Billing Director 561-715-9288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2013-06-17 |