| NPI | 1124783477 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JENNIFER VANZANDT CFO 904-387-4661  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2021-11-02 | 
| Last Update Date | 2024-05-23 |