| NPI | 1104520436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHAN JILL HAMBLET-MOORE Owner 352-541-0421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-03-29 |