| NPI | 1225430036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCNER METELLUS Mental Health Therapist 407-756-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL IMH 10469) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2019-06-06 |