| NPI | 1083352769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERALYN THARP Officer Manager 850-889-2880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2026-08-24 |