| NPI | 1750816054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD O SPOONER Owner/Administrator 813-992-7867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |