| NPI | 1811693898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA EMMY LOPEZ CEO 321-443-6281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2025-05-13 |