| NPI | 1417498130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA IACULLO Billing Director 561-513-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |