| NPI | 1306690722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH P BRABHAM Manager/Proivder 813-575-0477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 251S00000X | |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-10-02 |