| NPI | 1477125516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURICE CAMPBELL Director 863-712-2774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 104100000X Social Worker | |
| 177F00000X Lodging | |
| 251B00000X Case Management | |
| 251V00000X Voluntary or Charitable | |
| 261QE0002X Clinic/Center Emergency Care | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2021-09-28 |