| NPI | 1831964766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHALAH LOUSE BATTO Registered Agent (Ra) 954-353-3387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2026-03-18 |