| NPI | 1235716630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK M EWING Office Manager, Vice President 941-800-4924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-01-18 |