| NPI | 1124501457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY PRAT Executive Director 754-281-2816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2018-09-12 |