| NPI | 1467923078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN NEEDELL Ur 561-715-3260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-12-07 |
| Last Update Date | 2018-12-07 |