| NPI | 1548794480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLA RAJARAM Billing Manager 954-272-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2022-09-30 |