| NPI | 1700778578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL SWEIKERT Billing & Credentialing Specialist 772-220-3439 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2025-07-16 |
| Last Update Date | 2025-07-16 |