| NPI | 1942363072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID AGNOLUCCI Owner Operator 772-460-5053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 15-56-AD-1597-00) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |