| NPI | 1417623778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY DAVID BERRY Owner/Therapist 904-527-5202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |