| NPI | 1437674769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY FLEMING Director 904-894-1736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH13530) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME102872) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2022-07-21 |