| NPI | 1811540289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE KASSELLA Provider Owner 863-634-2672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| 314000000X Skilled Nursing Facility | |
| 251E00000X Home Health | |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2021-07-22 |