| NPI | 1821633587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LYMBURNER Member 727-403-7847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 101YP2500X Counselor, Professional | |
| 103TC0700X Psychologist, Clinical | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-11-16 |
| Last Update Date | 2019-11-16 |