| NPI | 1801496302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERITA CHANG Administrator 954-993-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2024-08-22 |