| NPI | 1326475708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WILLETS Manager 863-614-0034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 2300) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |