| NPI | 1760610117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL AZZINARO Chief Executive Officer 267-639-5185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: PA 807409) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |