| NPI | 1700320942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIEGO RODRIGUEZ Counselor 407-978-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL 4901) |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2022-07-21 |