| NPI | 1124783477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA MERCADO Director Of Um/Ur 904-718-8606 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2026-02-19 |