| NPI | 1053073304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY SIMONE CRIDER CEO 786-300-7080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2021-10-13 |