| NPI | 1760191548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYDIBIS BLANCO-ALONSO Owner 786-300-6316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-11-21 |