| NPI | 1477493500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM HOUSTON Credentialing Manager 786-791-7529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2026-03-30 |
| Last Update Date | 2026-03-30 |