| NPI | 1639507999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BHASKAR N. RAJU Director 352-241-6112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL ME91130) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |