| NPI | 1376992388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA POTREKUS PEREZ Office Manager 863-824-3447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |