| NPI | 1265057889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAZARO ARIEL COLLADO Owner 786-712-6680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2020-06-09 |