| NPI | 1326597774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA PETITE LEE President 904-514-9788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2017-11-14 |