| NPI | 1740472174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN VACCHELLI Owner 386-446-5494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2013-11-18 |