| NPI | 1518743152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERITA CHANG Cro 954-993-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2023-11-03 |