| NPI | 1174864276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY MIRABILE Owner 904-551-1394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2024-08-30 |