| NPI | 1932557006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLA RAJARAM Billing Manager 954-272-6723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2018-07-20 |