| NPI | 1790220465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE FUENTES Founder/Owner 305-510-6423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH10778) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2017-02-27 |