| NPI | 1104798610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DILLON OTT Co Owner 904-501-5850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-09-23 |
| Last Update Date | 2025-09-23 |