| NPI | 1104965268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY MANUEL President 407-774-2284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 015664400) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH 11048) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2017-01-24 |