| NPI | 1063120392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE BUNTIN President 321-246-4581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2022-11-07 |