| NPI | 1275078560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE REUTER Owner 561-818-9901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 5001) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2022-07-21 |