| NPI | 1598039844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY S FLOYD Owner/Manager 386-690-9585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW9595) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |