| NPI | 1629457874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLIS WIDDEKIND Clinical Social Worker 954-663-2475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW 12779) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2023-12-08 |