| NPI | 1245552876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY T DURHAM Owner 321-733-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 000389) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2010-02-23 |