NPI | 1700066073 |
---|---|
Entity Type | Organization |
Authorized Contact | DAN EDWARD DARRISAW CEO 772-528-6628 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 688140896) |
Enumeration Date | 2007-11-05 |
Last Update Date | 2017-03-17 |