NPI | 1760376529 |
---|---|
Entity Type | Organization |
Authorized Contact | GERTIE MALLARD-TEAL Owner 813-467-9693 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2025-06-05 |
Last Update Date | 2025-06-05 |