| NPI | 1871963124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SLYVING DATON BOURDEAU President/CEO 407-470-5908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW11513) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2015-09-30 |