| NPI | 1154926947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICK ESPINOZA Officer 786-842-1489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2025-03-24 |