| NPI | 1467775676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A. HAMILTON Practice Manager 941-697-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2019-08-26 |