| NPI | 1972003523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERITA CHANG Cro/Partner 954-993-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1019010) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2023-04-27 |