| NPI | 1821456799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT PRICE HOSFORD Owner 352-318-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL MH 854) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL MH 854) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |