| NPI | 1164863809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY WILLIAMS Vice President 407-581-5157 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2019-08-08 |