| NPI | 1194143263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM MICHAEL FRANCIS Owner Operator 850-443-4203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CO CHR0007058) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2014-04-04 |