| NPI | 1174214886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERMESHA POWELL CEO 321-348-7845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-05-15 |