NPI | 1366796062 |
---|---|
Entity Type | Organization |
Authorized Contact | TWILA ALISA ROULHAC Masters Level Counselor 850-628-7847 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 101ym0800x0) |
Enumeration Date | 2012-11-01 |
Last Update Date | 2012-11-01 |