| NPI | 1053858365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BETANCUR Therapist 813-777-7407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL sw12475) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |