| NPI | 1063909760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY CONNOLLY Director Of Revenue 954-857-4976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2025-01-17 |