| NPI | 1972647899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS GEORGE GLAZA CEO Clinical Director 941-876-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL SR-58-AD-2079-01) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2014-11-03 |