| NPI | 1649738220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNDRA ERICA MAINE CEO 954-703-1165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2020-06-22 |