| NPI | 1295894301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE LINDA LANESE President Center For Identity Devel 954-345-5525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2014-07-29 |