| NPI | 1114805165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILNISE MATHIEU Office Manager 954-251-0267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QC1500X Clinic/Center, Community Health | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2025-08-26 |
| Last Update Date | 2025-08-29 |