| NPI | 1679263644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES GREGORY CHAUNCEY Owner 352-650-0883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2023-09-23 |