| NPI | 1861076150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE BAGLEY Chief Financial Officer 305-663-1876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2021-05-12 |