| NPI | 1598433534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN COSIMI CEO 386-236-1811 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 284300000X Special Hospital | |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2021-09-09 |