| NPI | 1437675196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURTIS LEE CHAMBLISS Owner 407-201-3766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL MH14831) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2022-10-03 |