| NPI | 1275998767 |
|---|---|
| Doing Business As | SOUTHSIDE COUNSELING CENTER |
| Entity Type | Organization |
| Authorized Contact | CARMELLA C GARDNER Owner 904-292-2497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL mh8370) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2016-02-11 |