| NPI | 1366845349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BRITT Practice Owner 904-466-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH7352) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2014-10-03 |