| NPI | 1962881821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA A MACK Owner/Therapist 727-709-7751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH 12718) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-27 |