| NPI | 1033001623 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CHRISTOPHER JAMES CERTAIN Manager/Therapist 813-451-2753 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health | 
| Enumeration Date | 2025-07-17 | 
| Last Update Date | 2025-07-17 |