| NPI | 1720446909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY BOURNE Owner 727-314-1224 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2016-10-24 |