| NPI | 1528165909 |
|---|---|
| Doing Business As | CRC |
| Entity Type | Organization |
| Authorized Contact | JIMMIE P. HICKS Clinical Director 904-358-1211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: FL 305S00000X-Point of) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-20 |