| NPI | 1770260119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOREEN K. DWYER Member 941-999-1041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2023-06-28 |