| NPI | 1457628646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MATTHIAS KELLY President 305-872-3187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW3573) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2011-11-16 |