| NPI | 1760806764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEXTER D HEAD Facility Manager 772-219-4041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2014-02-11 |