| NPI | 1922553056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE MARIE LOPEZ Owner/Behavior Analyst 321-890-4038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 1-16-22688) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |