NPI | 1376320531 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY D REYNOLDS Owner 352-777-9887 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
Enumeration Date | 2023-09-12 |
Last Update Date | 2023-09-12 |