| NPI | 1700113685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY A SAVAGE Owner/Practitioner 386-503-4388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 8612) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP 4540) |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2009-11-12 |