| NPI | 1053722462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHMOUD S HASSAN Owner 813-933-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH9342) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2022-02-24 |