| NPI | 1649400995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINDY HUELLE Owner/Operator 813-210-0394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL SW8858) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2009-07-21 |