| NPI | 1023186160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK RICHARDSON Licensed Clinical Social Worker 850-523-3289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL SW 8374) |
| Additional Taxonomies | 273R00000X Psychiatric Unit (Licence: FL SW 8374) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |