| NPI | 1457895625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL GITTENS President 772-215-5905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2017-07-22 |