| NPI | 1013755719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE SMITH President/CEO 904-365-8305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2024-07-17 |
| Last Update Date | 2024-07-17 |