| NPI | 1760460653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH JAY GLYNN CEO 941-639-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 0808AD492200) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 2008AD4922-00-P) |
| 251S00000X Community/Behavioral Health (Licence: FL 1477) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 0808AD492200) | |
| 1041C0700X Social Worker, Clinical (Licence: FL 0808AD492200) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2022-05-24 |