| NPI | 1740063668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REYNALDO LOPEZ Owner 407-284-0910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2024-04-01 |