| NPI | 1326585639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY RAY Managing Member 850-368-9373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 1-16-23681) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL MH14594) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |