| NPI | 1972054476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M DAVIS Managing Member 941-737-8897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH4468) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |