| NPI | 1033575394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BOUTHILLIER Owner 850-241-5707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW11731) |
| Enumeration Date | 2016-01-01 |
| Last Update Date | 2016-01-01 |