| NPI | 1467193623 |
|---|---|
| Doing Business As | SUD FAC OPT |
| Entity Type | Organization |
| Authorized Contact | JAY BOULDIN Research Director 321-989-2187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 261QR1100X Clinic/Center, Research | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2022-04-04 |
| Last Update Date | 2022-08-06 |