| NPI | 1164172789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA SOJOURNER Owner/Manager 407-720-9906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-26 |
| Last Update Date | 2022-03-26 |