| NPI | 1295276160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRILL VESSELOV President 561-635-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: IN 1759-0ASO) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2024-01-24 |