| NPI | 1245588441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE DONOHUE Owner 855-241-7160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL sw10454) |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2012-08-17 |