| NPI | 1639624711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLAS I. LEDON Owner 786-514-6362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH11659) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2023-11-29 |