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