| NPI | 1326301706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUITA ELSTON Therapist 321-281-3840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: FL 160994624) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |