| NPI | 1467008078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC SPIVEY Director 352-631-8568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2019-08-11 |
| Last Update Date | 2020-06-24 |