| NPI | 1962962662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA SMITH CEO 727-409-6239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-06-11 |