| NPI | 1427388834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH AMES Operations Manager 904-733-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL SW8820) |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2010-01-07 |