| NPI | 1780126755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARIBEL DELOSSANTOS Claims Supervisor 954-874-7923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 1706AD699801) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2016-11-08 |