| NPI | 1619351392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN TOSOLINI Provider Relations Manager 407-375-2565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 100045895) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2021-08-03 |