| NPI | 1104406362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA P GLYNN CEO 786-479-7041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2024-02-05 |