| NPI | 1760629406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY A REDMAN Single Sole Member 941-951-0343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PY3846) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2009-01-16 |