| NPI | 1417474735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE LUCILLE FAHRINGER Licensed Mental Health Counselor 813-494-0656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: FL MH13259) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2022-07-21 |