| NPI | 1700034733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP EDWARD VAN KLEECK President 863-991-5209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL MH9545) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |