| NPI | 1053808063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS PARADISE Clinical Director 772-924-4163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-06-16 |