| NPI | 1417532417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC TEDOFF Owner 561-401-5163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2021-03-11 |