| NPI | 1962835488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CICI KELLY Chief Executive Officer 954-764-7337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1706AD094501) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: FL 1706AD094501) | |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2021-02-04 |