| NPI | 1013456862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENET'E BENJAMIN Owner 904-352-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH14724) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |