| NPI | 1194705236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE ANN CRUCE Controller 850-872-7676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 0203AD234501) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 0203AD234501) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2020-08-22 |