| NPI | 1528692928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH O'HERN Owner/Registered Agent 321-802-1237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |