| NPI | 1417317926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN TORRENCE TATE Executive Director 863-697-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 000975100) |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2016-02-25 |