| NPI | 1003198409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY THEIN Executive Director 321-421-6992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW9134) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2014-01-08 |