| NPI | 1073381810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERITA CHANG Cro 954-993-2040 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2023-12-12 |
| Last Update Date | 2023-12-12 |