| NPI | 1124794177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE ROMER Owner 813-576-0768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2021-08-19 |