| NPI | 1356499917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOB MCQUEEN President 904-269-5356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 1808) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL mh-4271) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |