| NPI | 1124499546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH LEON BERG Clinical Director 305-822-7202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL sw6104) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: FL sw6104) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2015-10-12 |