| NPI | 1477084853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELYSE JOAN SALLEY Owner 407-697-5973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 11518482) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |