| NPI | 1356704423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | N RAJARAM Billing Manager 954-272-6723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |