| NPI | 1205272796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA GUERAO Director 321-749-6862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: FL 11151) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL 11161) |
| Enumeration Date | 2013-05-11 |
| Last Update Date | 2013-05-11 |