| NPI | 1689115362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLA RAJARAM Implementation 954-272-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: NC MHL-001-366) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |