| NPI | 1003314790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERLAND BAKER Director 904-323-2019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: FL 15468) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL 15468) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 15468) | |
| 101YM0800X Counselor, Mental Health (Licence: FL 15468) | |
| Enumeration Date | 2018-01-27 |
| Last Update Date | 2018-04-05 |