| NPI | 1780142448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN COTHRON Owner 407-965-6708 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2024-06-28 |