| NPI | 1477032548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCIO LIRA Community Coordinator 561-420-3012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-09-20 |