| NPI | 1063275170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHATIRIA M. JOHNSON Manger 786-910-3212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-15 |