| NPI | 1548621030 |
|---|---|
| Doing Business As | THE FOURMULA |
| Entity Type | Organization |
| Authorized Contact | ROBIN LEIGH GUTERMAN-PERRY Owner/Manager 561-617-1925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL SW10458) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL SW10458) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: FL SW10458) | |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2017-08-18 |