| NPI | 1265018543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA BETANCOURT Owner 786-797-3791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2022-01-19 |