| NPI | 1134643273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH JEANINE ROUSSO Owner 850-677-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: FL 15252) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2025-08-25 |