| NPI | 1164535092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN MICHELLE GORDON Clinical Therapist 954-341-7774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: FL SW8335) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2009-02-03 |