| NPI | 1710702451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL MARK BURGAN Chief Operating Officer 727-416-2322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |