| NPI | 1639339898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER WADE BOTKIN Managing Director 941-812-5321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH9485) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2016-05-19 |