| NPI | 1174029664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSA E SMITH Owner/CEO 239-202-0932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL SP014025) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2022-09-20 |