| NPI | 1144891680 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DANA PATRICE DENSON Owner 407-334-7726 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2021-07-06 | 
| Last Update Date | 2021-07-06 |