| NPI | 1457457962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA A GUARINO Credentialing Specialist 850-523-3261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2026-01-23 |