| NPI | 1053902767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANIA MERCEDES SIMON President 786-416-0811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2024-09-23 |