| NPI | 1770916264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE GIBSON-JACOBOWITZ CEO 352-622-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10396) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2021-09-09 |