| NPI | 1821762170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN TOSOLINI Provider Relations Manager 407-375-2565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2021-08-02 |