| NPI | 1578677076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAYTON RANDALL MCALLISTER Chief Financial Officer 850-634-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: FL 26039072238) | |
| 208D00000X General Practice | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-08-13 |