| NPI | 1528709672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA GASKINS Fiscal Relations Supervisor 904-291-5561 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-03-20 |