| NPI | 1497092282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DICKEY Director 954-678-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: FL CLIA) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-18 |