| NPI | 1639632326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA RABB Owner 239-634-9896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2020-01-16 |