| NPI | 1083035554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISTAN FAITH Owner 407-223-8873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH10201) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2014-01-15 |