| NPI | 1124315759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAYRA LIZARDO Lcsw 754-207-7915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW9141) |
| Enumeration Date | 2011-07-04 |
| Last Update Date | 2025-01-03 |