| NPI | 1023326014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WILLIAM JACKSON Executive Director 904-808-8373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |