| NPI | 1750803144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA WANZA Provider/President 305-654-7251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2021-03-08 |