| NPI | 1548753544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELORES TRICARICO President/CEO 941-626-0214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: FL MH12573) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH12573) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2018-06-13 |