| NPI | 1518434471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSA MERCADO Owner 862-258-6566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2018-10-30 |