| NPI | 1164975496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE HUMPHREYS Manager 850-895-1070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |