| NPI | 1639405533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINDY STAUM Social Worker 954-464-1393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL ISW4315) |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2009-10-27 |