| NPI | 1326790262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRILL VESSELOV CEO 561-305-0461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2023-11-14 |