NPI | 1669155800 |
---|---|
Entity Type | Organization |
Authorized Contact | SIDRAYA BUSSIE Owner 904-728-8021 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-08-14 |
Last Update Date | 2023-08-14 |