| NPI | 1558960617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURICIO LOPEZ Manager 954-496-1667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-21 |