| NPI | 1366991416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE MAUGHN Adm 954-579-9935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 1380) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 4015A) |
| 106S00000X Behavior Technician (Licence: FL 1216) | |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |