| NPI | 1417779471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSSA BASS Owner 407-768-3729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |