| NPI | 1114382850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEA JOHNSON Owner 352-638-6639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW6891) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2015-12-23 |