| NPI | 1609231653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELI KORNMILLER Senior Credentialing Specialist 561-672-8345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 1550AD404201) |
| 251S00000X | |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |