| NPI | 1417536145 |
|---|---|
| Doing Business As | PROVIDERS FOR HEALTHY LIVING |
| Entity Type | Organization |
| Authorized Contact | MATTHEW LOWE CEO 407-219-3281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2023-08-24 |