| NPI | 1306478797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEKESHA ELLISON VP Of Operations 904-888-4634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |