| NPI | 1598203663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA KAZAKOS Sole Member 850-483-1422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW5281) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-02-08 |