| NPI | 1659239051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY TAIT-MOSS SVP 954-380-1507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2026-01-13 |
| Last Update Date | 2026-05-01 |