| NPI | 1285075051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILEEN L VANDENOEVER President 904-755-1914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW8163) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2013-07-09 |