| NPI | 1962959940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA ELAINE HOLLYWOOD Manager 863-446-2853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12709) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |