| NPI | 1740744390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZANNIA FABIOLA FALERO VIGOA V.P. 786-768-0184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-02-27 |