| NPI | 1013538800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADINE L GOUSSE Psychotherapist 786-318-8732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-05-03 |
| Last Update Date | 2020-05-03 |