| NPI | 1215123195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT OLDS Owner 904-834-9647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME35901) |
| Enumeration Date | 2007-09-24 |
| Last Update Date | 2024-05-16 |