| NPI | 1891704847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FALLON DEROSA VP Of Human Resources 321-722-5273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 251S00000X | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2024-04-16 |