| 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 |