| NPI | 1215476551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEL KORNMILLER Onboarding Manager 561-672-8345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 3501) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2022-07-21 |