| NPI | 1104579424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA GREENOUGH CEO 904-829-2273 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2022-01-27 |