| NPI | 1235520248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANENE ROBINSON-KYLES Manager 863-614-3232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PY8015) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2015-02-12 |