| NPI | 1427803808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA JEAN BROWN VP 386-451-2346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2024-04-19 |