| NPI | 1326869017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMADOR REYES Consultant 786-253-7699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-10-24 |