| NPI | 1790722031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW GISSEN President 305-751-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1113AD381002) |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: FL 1113AD381002) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-08-22 |