| NPI | 1790521755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN PONDS Owner 321-746-5386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| 251B00000X Case Management | |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-16 |