| NPI | 1568823508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY JO DONNELLY COO 352-622-3725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 0542AD045901) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2016-03-18 |