| NPI | 1083066971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADIANE PEREZ Manager 786-732-0607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 10803) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL BACB 1-15-21803) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2026-06-04 |