| NPI | 1235536491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB PISTOR PISTOR Office Manager 561-877-8753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |