| NPI | 1265368534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER REECE VAN BERKUM Manager 863-205-6109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2026-06-23 |
| Last Update Date | 2026-06-23 |