| NPI | 1790157626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANA LOPEZ Officer Mgr 407-823-8421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MO 2000143660) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-10-30 |