| NPI | 1629516471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE TERREZE PRINCE Owner/ CEO 850-398-2799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL MH 12991) |
| Additional Taxonomies | 251S00000X (Licence: FL ADC-003834-2014) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |