NPI | 1063974806 |
---|---|
Entity Type | Organization |
Authorized Contact | JACQUELINE DOUGHERTY Owner 904-447-7525 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2019-04-02 |
Last Update Date | 2019-04-02 |