| NPI | 1356170518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BOWEN Owner 904-600-1662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2025-01-29 |