| NPI | 1588269310 |
|---|---|
| Doing Business As | YEAR |
| Entity Type | Organization |
| Authorized Contact | TIFFANY HART Billing & Credentialing Specialist 904-300-7494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2020-12-01 |