| NPI | 1003353095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HOFMAIER Lmhc 772-631-0591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL MH 12219) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |