| NPI | 1124381082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA R ORTEGA Director 786-592-0940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MT 2451) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2012-06-15 |