| NPI | 1427736545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREEANA E ROBERSON Owner 786-560-7496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-21 |