| NPI | 1235400938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE FLORES Billing Coordinator 754-201-2265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1706AD870001) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-12-04 |