| NPI | 1801691126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE DIXON Owner 727-614-6118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-02-19 |