| NPI | 1245736057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SAINT LUC Owner 561-713-4819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 1005270) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2018-04-02 |