| NPI | 1295036424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY BLANTZ DIXON Director 904-779-1777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: FL 8840) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2010-11-04 |