| NPI | 1841676533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIDA RODRIGUES Clinical Instructor 984-974-4863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 276400000X Rehabilitation, Substance Use Disorder Unit |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2015-08-04 |