| NPI | 1790259315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN C. HEELAN Mgr 561-252-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-07-01 |