| NPI | 1962859009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BOTERO CEO 954-614-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL ME63855) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ISW3945) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH11418) | |
| 101YP2500X Counselor, Professional (Licence: FL MH 10146) | |
| 106H00000X Marriage & Family Therapist (Licence: FL IMT1330) | |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |