| NPI | 1972015238 | 
|---|---|
| Doing Business As | OM CENTER FOR WELLNESS | 
| Entity Type | Organization | 
| Authorized Contact | MARITSA YZAGUIRRE-KELLEY CEO 754-812-1599  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11108)  | 
| Enumeration Date | 2017-10-26 | 
| Last Update Date | 2021-06-10 |