| NPI | 1528723640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER L SEIFERT Owner 407-212-5589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 282J00000X Religious Nonmedical Health Care Institution | |
| 302F00000X Exclusive Provider Organization | |
| 302R00000X Health Maintenance Organization | |
| 305S00000X Point of Service | |
| 333600000X Pharmacy | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2021-11-03 |