| NPI | 1942783808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE MAHAN Licensed Mental Health Counselor 407-325-7940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL MH13869) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |