| NPI | 1699573543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN COSIMI CEO 386-236-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-03-06 |
| Last Update Date | 2025-03-06 |