| NPI | 1366172298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARTER BRANLEY Member 941-855-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2022-06-14 |