| NPI | 1053709261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA SMITH Billing Manager 954-800-8387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2016-12-29 |