| NPI | 1245615863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY HAWKINS Owner 561-832-4780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: FL 10D2032848) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2016-04-14 |