| NPI | 1336770957 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | EGUENEL LOUIS Owner 561-670-8825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-02-01 |
| Last Update Date | 2020-02-01 |