| NPI | 1770841959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANA MANKO Vice President 561-409-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: FL 10d2044371) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 111N00000X Chiropractor | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2016-04-11 |