| NPI | 1992261663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA WISDOM CFO 954-771-2091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2020-05-20 |