| NPI | 1659452563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN DELALLA Administrator 561-637-2592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: FL RN1647982) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 0950ad982501) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |