| NPI | 1386223469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY HART Credentialing/Billing Manager 904-300-7494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 174H00000X Health Educator | |
| 251B00000X Case Management | |
| 251E00000X Home Health | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2024-04-19 |