| NPI | 1073295259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH RYAN CAGGIANO Co Owner 321-800-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-01-27 |