| NPI | 1629360037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MARIE COTTRILL Owner 941-773-8758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |