| NPI | 1871966051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY LAWRENCE MCNEIL Executive Director 386-677-5376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL MH3217) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2015-11-10 |