| NPI | 1144594078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RISE H PAGE Owner 407-970-0084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2018-10-12 |