| NPI | 1902802002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL E DOZIER CFO 352-315-7532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: FL 4075) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| 251B00000X Case Management | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2012-07-18 |