| NPI | 1396351565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIGERIA K MCHELLON Owner 904-450-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |