| NPI | 1679186589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURINA ALVARADO Executive Director 850-694-6311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-08-29 |
| Last Update Date | 2020-09-12 |