| NPI | 1881349660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIDICE GISEL CARRILLO CABRERA Administrator 954-900-2931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-02-19 |
| Last Update Date | 2022-02-19 |