| NPI | 1487008546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LARA Owner, Lmhc, Bcba 904-596-9986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL MH12293) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-04-14 |