| NPI | 1386800720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA MINKIN Clinical Psychologist 954-983-7457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: FL 5829) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: FL 5829) |
| 305R00000X Preferred Provider Organization (Licence: FL 5829) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2010-05-21 |