| NPI | 1093522047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO-ANN PRISCO VP Of Contracts 772-216-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-12-13 |
| Last Update Date | 2024-12-13 |