| NPI | 1528561842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLESA POOLE Owner 352-208-4497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DC LC50081368) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2019-02-06 |