| NPI | 1124476817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE ARMANDO GUERRA-VALENCIA Managing Member 786-514-2450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: FL ME121917) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL ME121917) |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: FL ME121917) | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2018-07-18 |