| NPI | 1033040977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATIANNA DENISE FISHER Owner 321-246-6974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251X00000X Supports Brokerage |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 251B00000X Case Management | |
| Enumeration Date | 2026-05-28 |
| Last Update Date | 2026-05-28 |