| NPI | 1568011138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRISHA N GLOSTER Owner 954-261-6604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2023-05-09 |