| NPI | 1700472180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLINS KUKWA AYEAH Administrator 954-544-9065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2024-10-02 |