| NPI | 1801084306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS WILLIAM CLYBURN Sole Proprietor 941-224-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH0007314) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |