| NPI | 1881306439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANEIL FESEFELDT Doo 954-654-2350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2024-10-09 |