| NPI | 1770949075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELI KORNMILLER Senior Credentialing Specialist 561-672-8345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1706AD094501) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2016-01-27 |