| NPI | 1902518848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE MOLINA Director Of Credentialing & Contrac 954-533-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-12-22 |
| Last Update Date | 2022-12-23 |