| NPI | 1790051142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA WILSON President 727-374-0108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL SW4971) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |