| NPI | 1033574074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LEE EAMES Owner 321-431-2457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL MH4980) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |