| NPI | 1376828178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXINE JOAN MINTO President 407-536-5375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: FL ME69898) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: FL ME69898) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-10-13 |