| NPI | 1497855100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA KLINE Owner/Director 850-572-5108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: FL 688059296) |
| Additional Taxonomies | 251C00000X (Licence: FL 688059298) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2008-04-27 |