| NPI | 1508649955 |
|---|---|
| Doing Business As | REVITALIZE COUNSELING CENTER |
| Entity Type | Organization |
| Authorized Contact | DORY RICHARDS Owner 352-606-0323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |