| NPI | 1013450105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THANIA VALLEDOR QUESADA Medical Director 954-385-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |