| NPI | 1366828659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUELA NURSE Administrator 561-412-1553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 10D2090158) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 1550AD652001) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2016-04-19 |