| NPI | 1194803734 |
|---|---|
| Former Legal Business Name | BEACON CLINIC |
| Entity Type | Organization |
| Authorized Contact | NOEL E HOLDSWORTH Director 941-629-7855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL NP2596452) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |