| NPI | 1982188694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY JR RIVERA CEO 786-970-9843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2021-05-20 |