| NPI | 1053904946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA RODRIGUEZ GARCIA Manager 786-630-3417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2021-02-11 |
| Last Update Date | 2021-04-03 |