| NPI | 1366271108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREY RYAN Owner 352-448-1380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-07-30 |
| Last Update Date | 2024-08-02 |