| NPI | 1720325574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE D BOUTROUILLE Owner 954-340-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME87029) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: FL ME87029) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-03-27 |