| NPI | 1992221352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KISHMA VICTOR CEO 954-488-9202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-07-21 |