| NPI | 1790569085 |
|---|---|
| Former Legal Business Name | MENDING MINDS MENTAL HEALTH SERVICES LLC |
| Entity Type | Organization |
| Authorized Contact | BRIAN CLUKIE Administrator 813-997-2099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-09-28 |