| NPI | 1609455872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA TERESA PUENTES Owner 786-274-3549 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2021-05-11 |