| NPI | 1184929846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA SMITH Credentialing Agent 954-746-8232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 1550AD032703) |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2014-11-26 |