| NPI | 1295965234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN WILLIAMS Co Owner, Registered Agent 321-297-7505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 1-05-2284) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL MH8246) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2009-07-24 |