| NPI | 1194459297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRAVIL JOSEPH CEO 352-602-7924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2022-07-13 |