| NPI | 1700759974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO A LARACUENTE Executive Director 954-451-1743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 364SF0001X Clinical Nurse Specialist, Family Health | |
| Enumeration Date | 2025-09-24 |
| Last Update Date | 2025-09-24 |