| NPI | 1811154933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY JEAN COOPER Therapist 813-677-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH9004) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-05-16 |