| NPI | 1922288497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORCAS IRIS DE JESUS Registered Agent 786-413-8487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL mh6847) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2009-02-20 |