| NPI | 1255837811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN WOLF WEBER Owner/Operator 813-679-4885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: FL PY10088) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2018-04-03 |