| NPI | 1992789549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA WHITE CLAVEY Outpatient Therapist 941-782-4299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: FL MH5954) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2020-08-22 |