| NPI | 1588203491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT RICHELSON President, Secretary,Treasurer 904-605-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2022-12-30 |