| NPI | 1083143689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELE ALEXIS TREVATHAN C0 Owner 561-463-2073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH1226) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2017-06-07 |