| NPI | 1720265275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD L HENDERSON President 772-466-6911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 687662596) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |