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 |