| NPI | 1275138620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS DIAZ Owner 786-506-1786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2020-12-03 |
| Last Update Date | 2024-08-12 |