| NPI | 1346544558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE BOLTON Owner 941-629-0282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL ARNP478692) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2011-01-03 |