| NPI | 1255614327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH BETH KERN Psychotherapist 954-881-0830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NJ 44SC05353600) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: NJ 44SC05353600) |
| Enumeration Date | 2011-09-24 |
| Last Update Date | 2020-08-24 |