| NPI | 1073024360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDINE ANNETTE MARTINEZ Executive Director 321-209-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2017-10-13 |