| NPI | 1538572854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA TOURKOVA Medical Director 941-677-3366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL 12-58-AD-4404-01) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |