| NPI | 1407221328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE MOLINA Director Of Credentialing & Contrac 954-533-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 283Q00000X Psychiatric Hospital | |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2022-12-09 |