| NPI | 1467836122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD ROUSSEAU Chief Administrative Officer 772-266-7682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CA 330130AP) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2018-07-03 |