| NPI | 1134394091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIANE PREVILMA Owner 954-274-8611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251E00000X Home Health |
| 252Y00000X Early Intervention Provider Agency | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |