| NPI | 1184972762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY ERIC GONZALEZ Mgr 561-703-2660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW9647) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |