| NPI | 1679205025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NYAISHA CUMMINGS CEO 772-678-6045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2022-06-25 |
| Last Update Date | 2022-07-22 |