| NPI | 1396016606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEDRIX DAKA CEO 904-423-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2015-03-19 |