| NPI | 1205900644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL K HAZELWOOD President 904-269-4783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP1893L) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH4540) |
| 101YS0200X Counselor, School (Licence: FL 614406) | |
| Enumeration Date | 2006-11-18 |
| Last Update Date | 2020-08-22 |