| NPI | 1639582661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN D GALLOSO Owner / President 954-770-2363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL SW8346) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2014-06-06 |