| NPI | 1619987856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FALLON DEROSA Hr Manager 321-722-5273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101Y00000X Counselor | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: FL 8599) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-02-28 |