| NPI | 1255716007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY VERCOSA CEO 561-290-3987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 10D2099194) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |