| NPI | 1720436504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEIGH GROOMS Owner 321-258-5942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH12676) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2016-06-02 |