| NPI | 1922358845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE KENNETH FERGUSON President 352-232-0839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-18 |