| NPI | 1346712726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT AARON DURRANCE Owner 850-807-0138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-12-22 |
| Last Update Date | 2020-01-22 |