| NPI | 1316560345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE ALINA DIJKHUIZEN Social Worker 850-502-0671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2022-06-06 |