| NPI | 1003602418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA AZIZAM KNIGHT Owner 321-290-0727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2026-02-19 |