| NPI | 1558663799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH ELIZABETH SOMERVILLE Administrator 321-984-8688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL AL7646) |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2010-11-19 |