| NPI | 1144975418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRAVIL JOSEPH Owner 305-767-0887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251S00000X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-15 |