| NPI | 1851696579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS A. OLIVA Director 407-767-0039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 1859AD468901) |
| Enumeration Date | 2011-01-12 |
| Last Update Date | 2011-01-12 |