| NPI | 1053819094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY OLIVER Manager 954-247-4157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2018-01-24 |