| NPI | 1649982273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY COPLIN Executive Director 727-284-8618 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2022-12-14 |
| Last Update Date | 2022-12-14 |