| NPI | 1295198208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN WILLIAM Administrator 561-863-5904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |