| NPI | 1285193425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARE W. SIMCOX Owner 727-510-4468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-03-18 |