| NPI | 1043878424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANTILAL BHALANI CEO 321-298-5531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2019-10-11 |