| NPI | 1508854571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN R AILES CEO/President 850-522-4485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2025-04-24 |