| NPI | 1962836163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRVING PORT CEO 954-900-4260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-08-25 |
| Last Update Date | 2018-06-20 |