| NPI | 1144598913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN IVETTE AYUSO Director 772-249-0177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2022-07-21 |