| NPI | 1407301757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BURKETT Office Manager 850-522-1516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 0301) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2022-07-21 |