| NPI | 1215179056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDI B BRAZER Director Of Operations 904-797-3115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 207Q00000X Family Medicine | |
| 208D00000X General Practice | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2011-05-19 |