| NPI | 1871755579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN ROSS CADDY Owner 954-565-8850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL py2093) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-12-02 |