NPI | 1053712125 |
---|---|
Entity Type | Organization |
Authorized Contact | CHANDA L. MOORE CEO 904-759-5089 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) |
363LP2300X Nurse Practitioner, Primary Care | |
364SH0200X Clinical Nurse Specialist, Home Health | |
Enumeration Date | 2014-09-09 |
Last Update Date | 2014-09-09 |