| NPI | 1295118230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA C WEST Director 863-207-4788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 9206) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 9206) |
| 106H00000X Marriage & Family Therapist (Licence: FL 9206) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2015-07-08 |