| NPI | 1659094142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE BYRON BROCCO Owner/Therapist 850-203-0214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2024-07-19 |