| NPI | 1427567353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN KANE Owner 727-514-4113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL MH13790) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2017-09-22 |