| NPI | 1629443395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI LYNN SRICHAN Clinical Counselor 850-819-5518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |