| NPI | 1982174066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA WISDOM CFO 954-771-2091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2018-12-03 |