| NPI | 1851471213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN TOSOLINI Provider Relations Manager 321-397-5251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2021-08-03 |