| NPI | 1043635972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENIA RODRIGUEZ Manager Supervisor 786-728-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103T00000X Psychologist | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2014-03-01 |
| Last Update Date | 2023-03-22 |