| NPI | 1376000604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MATTHEW KUCHTA Owner 850-358-8389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2019-02-22 |