| NPI | 1538604681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI MORTENSEN Owner 954-417-6545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PY7594) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2016-12-28 |