| NPI | 1518508779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAHINA BEASLEY Owner 954-399-0441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2024-04-24 |