| NPI | 1912537994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIAN HOLMES Owner 786-309-8132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-01-18 |
| Last Update Date | 2020-01-18 |