| NPI | 1033781000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMBERT WAYNE LEROUX Chariman 727-480-4981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2021-07-10 |
| Last Update Date | 2021-07-10 |