| NPI | 1881175925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY SANDERBECK Provider 727-295-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-09-24 |