| NPI | 1316479215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN COREY Owner 850-530-2960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL IMH15424) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |