| NPI | 1437447943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER REHBERG Treasurer 321-480-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2014-08-21 |