| NPI | 1467611947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL PADGETT Business Manager 863-452-3815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |