| NPI | 1023846268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DERICO Owner Lead Clinician 786-309-3442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-25 |