| NPI | 1972860799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIS KIMBROUGH Sole Proprietor/Owner 954-561-3112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW9190) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2012-04-18 |