| NPI | 1982421848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE LYNN PHELPS Owner 941-488-4811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-09-23 |