| NPI | 1346813177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE MARCELLE A MONVAL Administrator 772-242-1079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 251B00000X Case Management | |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2021-07-20 |