NPI | 1720961451 |
---|---|
Entity Type | Organization |
Authorized Contact | AMANDA SHANNON GILLESPIE Co Owner Clinical Social Worker 863-250-5447 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2025-07-29 |
Last Update Date | 2025-07-29 |