| NPI | 1467830471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEXUS WALLACE Administrator 407-656-2443 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL AL9894) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |