| NPI | 1205325297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEL M CEBALLOS-ROSARIO Owner 407-906-8633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: FL MH14780) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2021-10-04 |