| NPI | 1497038061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA POOLE Clinical Director 904-238-3638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |