| NPI | 1083966642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIDICE GISEL CARRILLO Targeted Case Manager/President 786-230-5396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2012-10-07 |
| Last Update Date | 2022-02-19 |