| NPI | 1144015645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA PAULK Consultant 904-840-7643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-04-24 |