| NPI | 1790976058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KWANYA SANDERS Executive Director 321-255-7991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 885021569) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2007-08-01 |