| NPI | 1306412259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINDOLYN SUBER President 239-601-3974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-01 |