| NPI | 1346844651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA ERISMAN Owner 813-468-7750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2020-11-27 |