| NPI | 1063967032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIGRID EZSA ALLEN Owner 561-876-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 5001) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2022-07-21 |