| NPI | 1578969796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA F LATIMER Owner 904-868-2182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH12959) |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2014-11-16 |