| NPI | 1518478940 |
|---|---|
| Doing Business As | POTENTIAL LIFE RECOVERY |
| Entity Type | Organization |
| Authorized Contact | JESSICA A WATKINS CEO 561-213-4103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2018-12-12 |