| NPI | 1255713764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY A PICILLO Billing Company 954-993-7165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP1600X Counselor Pastoral | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2015-06-19 |