| NPI | 1699167403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRES FELICIANO MAMBUCA Clinical Director 954-663-8086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL MH11089) |
| 252Y00000X Early Intervention Provider Agency (Licence: FL MH11089) | |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2019-04-12 |