| NPI | 1811373780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH A CLEMENTS Owner 813-625-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH10350) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-03 |