| NPI | 1902789803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DANIELA ORDUV Owner 786-836-2149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-07-28 |