| NPI | 1356680797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYISHA DERONETH Therapist 305-249-0521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW11065) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2013-02-05 |