| NPI | 1649895095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES EDWARD JARVIS Manager 561-425-2310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-06-18 |