| NPI | 1205447679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISIAH COLES COO 561-502-3978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 207R00000X Internal Medicine | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2023-06-05 |