| NPI | 1356946875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN RARING Clinical Supervisor 954-758-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251V00000X Voluntary or Charitable | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2020-12-02 |