| NPI | 1215735808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MOUNT President 904-699-2332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2025-03-07 |
| Last Update Date | 2025-03-07 |