| NPI | 1376939835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM RAEFORD FLETCHER Manager 321-543-3898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6655) |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2018-06-05 |