| NPI | 1396159331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY C SCHRADER Owner 727-446-8142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH4553) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP388) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |