| NPI | 1013577956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN MARIE NORTH Managing Member 813-455-8672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |