| NPI | 1669913430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALLAN BOMBKA President 407-463-4907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: FL MH7297) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |