| NPI | 1144730003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLENE V BERKEL Clinical Counselor 863-500-2480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL ISW12071) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2017-10-05 |