| NPI | 1932595899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINT TOLMAN Director 954-678-0078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 13414) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: UT 13415) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: UT 10218) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |