| NPI | 1720617335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULINE ALLEN Mgr 321-414-2248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2020-04-16 |