| NPI | 1245086040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL DRIEST Owner 904-370-3420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-04-24 |