| NPI | 1508521964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMARILYS DE JESUS GOMEZ Owner 786-223-7754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2021-11-15 |