| NPI | 1619360641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIANET GONZALEZ President 786-759-8995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2021-08-16 |