| NPI | 1912034232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE J GRADY Chief Operations Officer 305-525-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WV 35) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-12-09 |