| NPI | 1952707101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE BOSTOM Director 561-795-0018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |