| NPI | 1255827838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORREY DALGLEISH Owner/Operator 772-353-0660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL MH15801) |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2018-07-06 |