| NPI | 1548625007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH GRAHAM RUSS President 561-201-7180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2021-08-02 |