| NPI | 1093183972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDY MOLDT Manager 561-859-3185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2017-03-03 |