| NPI | 1124441175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET DIANNE CONSTANTINE President 904-637-1708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: FL MH 3146) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2014-01-28 |