| 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 |