| NPI | 1356007934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM HOCHBERG Owner 239-888-4910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2021-11-09 |