| NPI | 1275946535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY WILUSZ Owner 850-301-0446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH-2007) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |