| NPI | 1063075000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM CHIDDO CEO 954-272-4073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-11-17 |