| NPI | 1801193131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE KACHMAR LEAVITT Licensed Clinical Soal Worker 561-968-8361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL sw2509) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2011-02-23 |