| NPI | 1447610712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALVADOR VILLEGAS Owner 786-404-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: FL TBA) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2022-11-11 |