| NPI | 1669251088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAIR-TIFFANY MCCORMICK Owner 813-701-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2024-12-18 |