| NPI | 1275891178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENNIE CARIAS WITHERUP President/CEO 904-536-3091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: FL AL#12086) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care (Licence: FL AL#12086) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2012-04-27 |