| NPI | 1467805465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANN FERGUSON Executive Director 386-527-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW10893) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |