| NPI | 1194124271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS TERWILLIGER Co Owner 561-530-4291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1550AD888601) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: FL 10D2076899) |
| 251S00000X Community/Behavioral Health (Licence: FL MH11053) | |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2015-10-16 |