| NPI | 1043694219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY GHENT Clinical Director 863-226-5081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2023-02-10 |