| NPI | 1124570189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMELLA GARDNER CEO 904-292-2407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL 251B00000X) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |