| NPI | 1699542910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA STEVENSON Mental Health Counselor 386-283-6331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2023-12-07 |