| NPI | 1093059784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRILL VESSELOV President 561-882-9821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 1550AD121401) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2023-11-15 |