| NPI | 1184078016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE TIERNEY Manager 850-656-1822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: FL SW8910) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |