| NPI | 1619777240 |
|---|---|
| Former Legal Business Name | THE BOSS RESIDENCE |
| Entity Type | Organization |
| Authorized Contact | MARA-JOANNE S DERINOR Manager 772-828-8041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2026-02-09 |