| NPI | 1043765605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYUNA RUIZ Manager 786-355-9682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL ME122666) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2022-06-10 |