| NPI | 1609113141 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CHARLES WESLEY ENLISH Clinical Director 407-740-8899 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL MH2166) | 
| Enumeration Date | 2013-01-03 | 
| Last Update Date | 2013-01-03 |