| NPI | 1760627905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY LYN OSMON Behavior Analyst 863-581-1583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2022-08-22 |