| NPI | 1205388824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE GARY Representative 561-692-3676 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2016-10-31 |