| NPI | 1578387817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATELAND KEITH Business Owner 941-367-2356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2024-12-30 |