| NPI | 1689991135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE J CRANE President 904-264-7099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: FL PY00002130) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2013-10-29 |