| NPI | 1245754480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDNA GWYNN CEO 954-288-6905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: VA S6808093) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2022-07-21 |