| NPI | 1104540038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA MARI ALLEN Mental Health Counselor 321-300-6171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |