| NPI | 1164092029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SOMMERS President/CEO 904-743-1883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2021-07-01 |