| NPI | 1699176842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CEDRIC MADDOX CEO 407-739-7603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL 5896) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL 5896) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL 5896) | |
| 101YP2500X Counselor Professional (Licence: FL 5896) | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-11-25 |