| NPI | 1619586179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENESSA THOMAS Licensed Mental Health Counselor 321-276-2007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2020-07-30 |