| NPI | 1336505395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFRED GRANT MCDOUGALL Owner 352-375-4440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH5756) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |