| NPI | 1992189633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TITUS SIMEUL TUCKER Clinical Therapist 954-559-6093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL ISW8493) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |