NPI | 1447554019 |
---|---|
Entity Type | Organization |
Authorized Contact | JEAN M LARSEN President 772-249-0880 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 1956AD422201) |
Enumeration Date | 2010-12-22 |
Last Update Date | 2010-12-22 |