| NPI | 1720437809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SAUER Registered Agent 407-733-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: FL SW9956) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL SW9956) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |