| NPI | 1659535243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IURI TIAGO MELO Owner 435-986-1805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: UT 52521653501) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2008-07-14 |