| NPI | 1588017933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHONDA HAROLYN HENDERSON Owner 772-333-6488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 13816) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ADC 010575 2015) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2016-07-21 |