| NPI | 1639965585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN COANE Manager 305-494-6165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-05-13 |