| NPI | 1922558386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXA VENSKI Owner 239-898-2051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL IMH14317) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-10 |