| NPI | 1255859146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN REEVES Counselor 352-317-2619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL MH15272) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2017-08-31 |