| NPI | 1174954739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RAE Assistant To CEO 772-337-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |