| NPI | 1417444605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS EWALD Manager 954-716-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2018-06-20 |