| NPI | 1740632363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER GORMAN President 772-233-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-11-16 |