| NPI | 1770457533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JASS Mgr 352-250-3579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-10-03 |
| Last Update Date | 2025-10-03 |