| NPI | 1558863787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA WHITFIELD Owner 229-296-0626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH11373) |
| Enumeration Date | 2018-03-04 |
| Last Update Date | 2018-03-04 |