| NPI | 1114454691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KISHMA N VICTOR CEO 954-488-9202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2022-07-21 |