| NPI | 1114597697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AILEEN DIEZ President 305-439-4434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2021-09-14 |