| NPI | 1457596678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRESE CURRY HARRISON Owner 904-786-6486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 690575796) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |