| NPI | 1700274172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDLYNE THELUSMA Clinical Director/Therapist 305-814-3437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2024-04-24 |