| NPI | 1063098812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN WILLIAMS Owner 813-803-2999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-12-07 |