| NPI | 1396362505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON KOLLINGER Billing 561-570-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2020-12-28 |