| NPI | 1225811409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH COOPER CEO 772-971-9197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2024-05-16 |