| NPI | 1144838681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALDO YOE SALAS President 786-205-4058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2024-11-16 |